Guaranteed Healthcare

I have been a Registered Nurse for over 20 years, and some of my experience includes working with the elderly in the Medicare Arena. Approximately 9 years ago, my 74 year old father had a stroke causing physical debilitation. He lived in a Nursing Home and was fed exclusively via a gastrostomy tube. While in the Nursing Home his G-Tube was accidently pulled out.

The Nursing Home transferred him to the hospital on a Saturday for it to be replaced. Medicare denied the claim, stating that it was not a medical emergency. They stated that it did not require an ambulance ride after hours and could of waited until Monday. Because of my background and experience, I called Medicare to speak to them about the denial. My argument was that it indeed was a medical emergency, as the gastrostomy tube was his only form of nutrition, and an elderly person (like a child), could not go without nutrition for 2+ days. After numerous phone calls and documentation, they finally paid the claim.

I feel that if I had not advocated for my 74 yo father, utilizing my medical and medicare background, my mother would have been forced to pay a claim, that my father was entitled to. The elderly have worked all of their lives and have paid into a program entitling them to the medical care they deserve. Thank You!